Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 13298 | Date 26/07/2025 |
| Token No | SM/25-26/1402 26/07/2025 | Serial | 003 |
| Patient Name | Mrs. SARMISTHA MUKHERJEE | Contact No | 7439926707 |
| Address | 28B THAKURBATI STREET | Age | 28 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||